How Auckland sex workers are keeping their STI rates down

March 13, 2026

When Wellington-based sex worker G is with a client, her use of condoms is akin to how an ER doctor might use latex gloves.

Most sex workers, like G, who asked to be referred to by her first initial, know a thing or two about STI prevention. STIs are a major workplace hazard for sex workers, similar to a builder avoiding a fall on a construction site or a doctor following protocol to limit contact with infectious diseases.

That diligence is paying off for rates of chlamydia and gonorrhoea transmissions amongst some sex workers in Auckland.

A new study published in the New Zealand Medical Journal on Friday shows that cisgender-female sex workers – so not male or transgender-female sex workers – who were tested at the Aotearoa New Zealand Sex Workers’ Collective (NZPC) clinic in Auckland had lower numbers of positive gonorrhoea and chlamydia results than females who attended a nearby general sexual health clinic. This mirrors similar results from overseas studies that looked at the sexual health of sex workers.

Know how and when to use and replace condoms for sexual health protection.

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“I think historically, sex workers have been highly stigmatised and often been blamed as being responsible for spreading sexually transmitted infections. So I guess the study is important to try and dispel some of those myths.”

She examined the test results of over 350 sex workers and close to 25,000 test results from the Auckland Sexual Health Service. One limitation of the study is the age of the data used, which came from test results over a two-year period ending in 2020, says Azariah.

“…it shouldn’t be considered representative of what might be currently going on in terms of STI prevalence in sex workers.”

Of the 1,342 tests completed by female sex workers, positive test rates for chlamydia were 5.1 percent compared to 9 percent of tests done with females at the general health clinic. Positive gonorrhoea test results were 3.9 percent for female sex workers versus 5 percent for females at the general health clinic.

Previous data from the NZPC found that rates of chlamydia and gonorrhoea were higher amongst street-based sex workers, according to the study, which highlighted the increased vulnerability to STIs of that group, as well as migrant sex workers.

Rates were also higher amongst the small number of trans-female sex workers involved in the study. Azariah says this highlights the increased vulnerability of that population, too, including higher incidences of workplace violence.

“In general, I would think that people accessing that [NZPC] clinic in which the study was based would tend to be a bit more vulnerable compared to people accessing other services for testing.”

G, is acutely aware of whose hand has come in contact with what body fluid and where that hand is headed next. If the client wants to touch her and his hand could have his body fluid on it, then she ushers him into the bathroom for a handwash first.

If the sex is particularly vigorous or long, that might warrant a condom change midway through, as condoms can get stretched, reducing their effectiveness. And the correct condom size is key for getting maximum protection from STIs (condoms significantly reduce STI risk, but do not eliminate it entirely). G has five different sizes on offer at every appointment.

An Auckland-based sex worker of eight years, who asked to be referred to as H, was not surprised by the study’s findings.

“I’ve found a lot of my friends just practise [unprotected] sex, you know, worst case, the taboo around it is maybe more about getting pregnant than the risk of STIs, where in our industry, if we have the risk of catching an STI, that can put us out of work for weeks at a time.”

H also pointed to the Prostitution Reform Act 2003, which requires both workers and clients to manage STI risk through tools such as condoms.

Her number one tip to reduce STI risk is to use a water or silicone-based lube because other lubes “can actually break condoms”.

Dental dams – thin, rectangular sheets of polyurethane or latex – should be used to reduce STI risk with oral sex, she added.

Both sex workers typically get STI testing done every three months and use their GP or a sexual health doctor rather than a NZPC clinic.

G’s main advice to anyone – sex worker or not – in sticking to best practices when it comes to individual sexual health and that of future sexual partners, is get regular STI testing.

“How regularly depends on what kind of sex they’re having and who they’re having sex with and how many people they’re having sex with.

“They should be having that conversation with a health professional who can advise them about how often they need to be tested.”

Worksafe’s guidance to sex workers also suggests inspecting client genitals for any visual signs of an STI. However, there is concern in the New Zealand sex industry that a visual inspection might give a false sense of security, says Cherida Fraser, a former sex worker turned sex industry advocate with NZPC.

When protection fails

When things go wrong, sex workers are often aware quickly, she says.

“Certainly if they have a broken condom… they know that the procedure is to come and get a test two weeks later.”

There are no contact tracing requirements for positive chlamydia and gonorrhoea results, but there is for more serious STIs such as Hepatitis B, says Fraser.

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Sex workers who have picked up something are not required to stop working because the use of condoms mostly eliminates transmission risk. Some workers might take a break due to discomfort, says Fraser.

However, managing the financial setback of not working can be tricky in an industry where sick pay is nonexistent. Some workers might bridge the income gap by creating content for sites such as OnlyFans, says G.

– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand

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